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Author Topic: Birth control and weight
dorey56
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So I've read a few studies that have said birth control is less effective in women who are overweight. I am on a low dosage birth control and am overweight (mind you I'm not obese but my bmi puts me in the overweight category). Should I be worried my pill isn't working for me? Should I especially be worried the inactive pills aren't working? Thanks!
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Heather
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So, here's the deal with that. In a word, we don't know if they are.

Effectiveness testing is generally done on people who are under 200 pounds. So, what the story is is that we don't really know if there is an effectiveness difference or not. It's sound to think there might be, but there also may not be. To my knowledge, there haven't been studies on people over that weight to refer to in the first place, though if something new has come out you've found, I'd be happy to take a look at it.

That given, though, doctors doing prescribing bear this in mind when they do, and they would not put you on a method they did not think would be effective for you. Some doctors up the dosage a bit for heavier people (though that's iffy, too, in terms of potential health risks). But if your doctor didn't voice any concerns about this to you, then they're not likely concerns you need to have yourself.

[ 01-02-2012, 09:13 AM: Message edited by: Heather ]

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dorey56
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Thats also kind of the conclusion I drew too from what I read. I for curious and just google searched the topic and read articles from CBS, womenshealth.org, sciencedaily, etc. they all said about the same thing. But tell me this, since I've been on this pill for over a year and have gotten my withdrawal bleed consistently on the 4th day of my inactive pills, (some cycles it was the 5th, but it's been a few months sense it happened on the 5th day) can I feel assured they are working? I have no doubts my doctor thought it through about putting me on this pill but I'm worried mainly because it's a low dosage pill and when she put me on it I weighed 25 lbs more too!
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Heather
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Really, what "working" only really means when it comes to the pill prescribed to prevent pregnancy is that you have not become pregnant.

And since, in one year of intercourse without any method, 80-90% of people who can become pregnant do, if you haven't, then yes, I think we can safely say it's working.

But again, I know of no study -- not an article, an actual study -- that has shown that for women over 200 pounds, these methods won't work. So, even worrying about this at this point strikes me as unfounded.

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dorey56
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Thanks heather I really appreciate it! I should have been more clear - I have not had sex while on this pill so that isn't something I can say has proved to me the pill is working. I'm no longer at that weight and haven't been for awhile. And the few articles/studies I saw said the risk of pregnancy while on birth control increases by 60-70% if your bmi is above 27 or so (mine is about 28.2) does that idea have any substance? I can attach the articles/studies I read if you'd like to see them.
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Heather
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I don't know why BMIs are coming up here. I also am confused that you seem to be talking about articles, but are also calling them studies: those are two different things.

If you are talking about a study or an article that references one, can you give me links so I can look at what you are?

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Heather Corinna, Executive Director & Founder, Scarleteen
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Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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dorey56
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Sorry again I must not be being clear enough. Some of the things I read were studies. Some were articles. They each refer to bmi as an indication of effectiveness so that's why I used it.


http://contraception.about.com/od/thepill/i/overweight_2.htm
http://m.cbsnews.com/storysynopsis.rbml?feed_id=0&catid=663817&videofeed=36
http://www.rodale.com/birth-control-effectiveness

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Heather
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So, going through the studies cited in these one by one, but here's the clear abstract for the one most talked about in the first, which states -- clearly -- weight was not found to be associated with lower effectiveness: http://www.ncbi.nlm.nih.gov/pubmed/12457519

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Heather Corinna, Executive Director & Founder, Scarleteen
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Heather
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Also, in that About.com article, I feel the author makes very clear that both studies clearly stated that findings of lower effectiveness may have been due to several factors, not just weight.

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Heather Corinna, Executive Director & Founder, Scarleteen
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Heather
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In this one -- http://www.rodale.com/birth-control-effectiveness -- what I'm seeing is possible evidence that women of greater weights may simply become pregnant more easily, period, including when using contraception. Since body fat as a good deal to do with fertility cycles, especially with the regularity of them, that actually doesn't surprise me.

I honestly can't make heads or tails of the Holt study, so that's one where I think I maybe just need some time to sit with it, hopefully being able to access the study as a whole, and read through it.

But again, I'm still not seeing real cause for concern here, especially if your prescribing physical has considered this. And if you back up with condoms, I don't think you need to worry about this at all.

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Heather Corinna, Executive Director & Founder, Scarleteen
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Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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dorey56
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Okay thank you! I appreciate the clarification because I guess all I was seeing was how it was a risk. I may be having sex on the placebo pills and just wanted to be sure that I wouldn't be less protected? after that question I just have a few more..how long can sperm survive in the body after vaginal sex? (many places and sources list different times). Next, if you have sex say 3 days before your withdrawal bleed, then get your with drawl bleed, is it possible for that sexual encounter have caused or to cause a pregnancy? And lastly, in respect to the sperm lifespan in a women's body after vaginal sex, if that time passes, whatever it may be, and you hasn't ovulated, does that mean you can't be pregnant? Thank you again do much heather - I know I ask a lot but I just want to be fully prepared!!
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Robin Lee
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You can feel assured these pills are working for you if you've been engaging in sexual intercourse while using no other forms of protection (such as condoms) and haven't gotten pregnant. This is the surest sign that this birth control method works for you.

YOu said something above about whether the inactive pills would work. The inactive pills don't have anything in them to work or not work. That's why they're inactive.

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Robin

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dorey56
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Well as I said before I haven't had sex on this pill since I've been on it. Could you maybe address my other questions as well? I had a bunch I'm quite curious about.
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Heather
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quote:
how long can sperm survive in the body after vaginal sex?
The usual estimate is anywhere from 3 - 7 days.

quote:
Next, if you have sex say 3 days before your withdrawal bleed, then get your with drawl bleed, is it possible for that sexual encounter have caused or to cause a pregnancy?
If someone is getting a period or withdrawal bleed, it's because they did not become pregnant. And with that timing, it'd be highly unlikely for someone to have an ovum for sperm to fertilize in the first place.

quote:
And lastly, in respect to the sperm lifespan in a women's body after vaginal sex, if that time passes, whatever it may be, and you hasn't ovulated, does that mean you can't be pregnant?
See above. Again, there has to be an ovum for sperm to fertilize in the first place. But since you're using a method that suppresses ovulation, this isn't really something that concerns you in the first place.

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Heather Corinna, Executive Director & Founder, Scarleteen
About Me • Get our book!
Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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dorey56
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Thanks heather!! That's really clear now. One last one though and I promise I will be done [Smile] if getting your period or withdrawal means no pregnancy, how come some professionals say you can get pregnant on your period? Is it because sperm can survive past the time of menstruation or something?
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Heather
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I don't usually hear repro health professionals saying that: I hear professionals saying that vaginal or uterine bleeding can still happen during pregnancy. And vaginal or uterine bleeding isn't the same thing as a period. It's laymen I hear saying "period" when they mean any kind of vaginal or uterine bleeding.

And vaginal or uterine bleeding CAN still happen with a pregnancy, it's just that if and when it does, it is not likely to come only when a period is expected, and look and feel like a period, including effects like PMS many people experience.

[ 01-02-2012, 12:35 PM: Message edited by: Heather ]

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Heather Corinna, Executive Director & Founder, Scarleteen
About Me • Get our book!
Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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dorey56
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Right that's what I've learned too. But by that question, what I meant was that I've heard that you can get pregnant during menstruation if you have a pregnancy risk while menstruating is that true? I'm assuming that means you'd have to ovulate during menstruation
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Heather
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No, it doesn't mean that.

Yes, you could, assuming you ovulated very shortly after menstruation AND enough viable sperm remained. For people who don't ovulate very early in their cycles, that would be unlikely.

But again: if you are using a combined pill, ovulation is suppressed for you, so that's not really about you anyway.

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Heather Corinna, Executive Director & Founder, Scarleteen
About Me • Get our book!
Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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dorey56
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Oh I gotcha now, that's what I was wondering. Thanks!!!!!!
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